[Intrapulmonary venous admixture during open heart surgery].
Monitor-computer study of changes in the ventilatory parameters, hemodynamics, gas exchange has shown that assisted circulation in patients operated on for acquired heart valve defects causes in the postperfusion period a 2-fold increase in intrapulmonary venous admixture (Qs/Qt), which accompanied an increase in alveolar-arterial difference (pO2) and a fall in arterial blood pO2. An increase in Qs/Qt upon assisted circulation is associated with a decrease in ventilation/perfusion pulmonary ratio and possible deterioration of diffuse processes due to hemodilution-induced water balance disturbances. Controlled lung ventilation with positive end respiratory pressure (5-8 cm H2O) partially decreases intrapulmonary shunting and improves arterial blood oxygenation. Positive effect, i. e. improved oxygenating lung capacity and decreased intrapulmonary shunting is achieved with water balance normalization due to early administration of diuretics upon assisted circulation.
Trekova
N A
NA
Flerov
E V
EV
Dement'eva
I I
II
Engoian
G V
GV
Ban'kov
A B
AB
D006348:Cardiac Surgical Procedures; D006801:Humans; D011650:Pulmonary Alveoli / Q000502:physiology; D011652:Pulmonary Circulation / Q000502:physiology*; D012119:Respiration / Q000502:physiology*
Vnutrilegochnoe venoznoe primeshivanie pri operatsiiakh na otkrytom serdtse.